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Bronchial Brushings Protocol

Department

Microbiology

Instructions

This Protocol Includes:

• Culture, AFB (CXAFB)
• Stain, AFB (STAFB)
• Culture, Anaerobic (CXANA)
• Culture, Respiratory (CXRES)
• Culture, Fungus, Routine (CXFUN)
• Stain, Fungus (STFUN)
• Culture, Legionella (CXLEG)
• Legionella DFA (LGDFA)
• Stain, Pneumocystis (STPCP)

NOTES

• If bronchial brushing is performed in conjunction with BAL only an aerobic culture (includes Gram stain) and anaerobic culture are performed.
• Stain for Pneumocystis jiroveci (carinii) will be performed on the bronchial brushing specimen, however the optimal specimen to detect Pneumocystis jiroveci (carinii) is BAL.

Specimen Collection Criteria

Collect: A double-sheathed microbiological bronchial brush in 2.0 mL of sterile non-bacteriostatic saline.

• To request this protocol, order in the Hospital Information System (EPIC oneChart) or write on the Microbiology request form, Bronchial Brush Protocol, and specify the specimen type.
• Secure lid to avoid leakage.

Physician Office/Draw Specimen Preparation

The specimen is stable at room temperature (20-26°C or 68-78.8°F) for a maximum of 2 hours, after which the specimen must be refrigerated (2-8°C or 36-46°F). Transport the specimen to the Laboratory within 4 hours of collection.

Preparation for Courier Transport

Transport: Specimen in a sterile collection container, refrigerated (2-8°C or 36-46°F).

Rejection Criteria

• Specimens collected in non-sterile containers.
• Leaking containers.
• Improperly stored specimens.
• Specimens containing preservatives (e.g., Formalin), or in a container that ever had Formalin in it.

Inpatient Specimen Preparation

Deliver the specimen to the Laboratory immediately after collection.

In-Lab Processing

A delay in processing of more than 1-2 hours may result in loss of recovery of fastidious pathogens such as S. pneumoniae and overgrowth of other microorganisms.

Storage

Specimen Stability for Testing:

Room Temperature (20-26°C or 68-78.8°F): 2 hours
Refrigerated (2-8°C or 36-46°F): 4 hours
Frozen (-20°C/-4°F or below): Unacceptable

Specimen Storage in Department Prior to Disposal:

Refrigerated (2-8°C or 36-46°F): 7 days

Laboratory

Dearborn Microbiology Laboratory
Taylor, Trenton and Wayne sent to Dearborn Microbiology Laboratory for testing.

Royal Oak Microbiology Laboratory
Grosse Pointe and Troy sent to Royal Oak Microbiology Laboratory for testing.

Performed

Sunday – Saturday, 24 hours a day.

Reference Range

No pathogens recovered.

Test Methodology

Concentration, stain, and culture.

Clinical Utility

To aid in the diagnosis of pulmonary disease caused by infectious agents.

Reference

1. Baron, E.J., and R.B. Thomson, Jr. 2011. Specimen Collection, Transport, and Processing: Bacteriology. Manual of Clinical Microbiology, 10^th ed., Versalovic, J., et. al., eds. American Society for Microbiology, Washington, D.C., pp. 228-271.

2. Gilligan, P. H., K. Alby, and M.K. York. 2016. Lower Respiratory Tract Cultures. Clinical Microbiology Procedures Handbook, 4th edition. ASM Press. Washington, D.C., Section 3.11.2. 

CPT Codes

87205, 87070, 87075, 87102, 87015, 87116, 87278.

Contacts

Last Updated

3/30/2021